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    An_250002 posted:
    take pain pills and often run out bye the end of the month sometimes they let me fill them up to 10 day early sometimes 5 or 2. if you run out how long should you wait before asking for a refill? the doctor has no ploblem when it comes to refill. ican get the scrip early but sometimes the pharmasest wont fill them
    peskypain responded:
    Hi there...If I can ask some questions...

    What is the reason you run out of medications each month? Usually a prescription is written to last for 30 days.

    It sounds like you are on a medication like Norco/Vicodin or Tramadol...These are the only ones that allow for actual refills.

    How many are you given each month and what does the prescription read for instructions (like take x amount every x hours)

    A Pharmacist is a part of your health care team and it is a red flag to be running out of meds each month. It's one thing to fill your meds 1-2 days in advance, but there is absolutely no reason to need a medication that is supposed to be for 30 days, 10 days early.

    The Pharmacist does have the right to not fill your prescription as well as even alert the state and/or DEA in that your Dr. is allowing this to happen each month.

    I would caution you in that with regulations getting more strict that this may all come crashing down in the future and your Dr. may get into trouble for letting you do this month after month.

    There are many other ways to help lessen one's pain from exercise, PT, injections, acupuncture, massage, ice, heat, TENS unit, biofeedback, just to name some...

    IF you have take your medication on schedule, and then tried literally every other thing to try and get the pain down, then you need to contact the Dr. to ask them what to do. This should be done instead of taking more pills than prescribed.

    By doing this each month, which means that you are getting a higher dosage of meds certain days, and then nothing for some days, this is only going to make your pain levels that much higher and harder to treat.

    I'm also surprised that your insurance company allows for such early refills as well. Just an FYI but most states now have a Prescription Monitoring System so that any Dr. or Pharmacist can see when/where you are filling your medication, how early each month, and whether you pay cash/use insurance. My point in stating this is that if you try to go someplace else they will be able to see this.

    I'm not trying to scold, just trying to say that you need to work with your Dr. on getting a better plan in place to handle your pain issues. As well as making sure you have a realistic view of what chronic pain is..this means that we will always have pain and a level 5 or so is acceptable after taking meds. By using other modalities, this can help lower your pain level a bit as well.

    I wrote all of this to caution you in that it may be where the Dr. decides this isn't working and cuts you off altogether and then it will be on your medical records that you aren't taking the meds responsibly which could make it where another Dr. does not prescribe anything for ppain that is controlled.

    That is the long answer...LOL...Again, we all know what it's like to be in pain...I hope you can figure this out with your Dr. soon.
    cweinbl responded:
    If you almost always run out of pain medication too early, then one of the following could be the reason:

    1. You are undermedicated. Either your medication is insufficient, the dosage is too low, the pain level has increased or you have become tolerant to the medication (or a combination of the above).

    2. You are deliberately using it other than as directed. You are taking it too often, using it too many times per day or taking too much at a time.

    3. You are using it for reasons other than for pain.

    I could add a #4 (you are giving or selling it to others), but I do not wish to accuse you. This happens far more often than anyone can imagine.

    It is critical to match the right medication and the right dosage for each patient's pain, ability to tolerate the drug and to avoid potentially serious side effects. Each of us has our own unique ability to benefit from any medication. Some of us very tolerant to opioids and require much higher dosages to manage pain. Others are very intolerant and must use very small dosages. Finding the right pain medication for any person can take months or even years to determine. In essence, you and your doctor must agree to try a dozen or so different medications, often in combination, to determine the best option.

    Chronic pain is best managed by adding an anti-depressant to your pain medication. They inhibit the reuptake of Seratonin in the bloodstream. Seratonin is one of the body's own pain-fighting chemicals. If you have neuropathic (referant) pain, adding an anti-convulsant can also help.

    Finally, if you have chronic moderate to severe pain, the best results are often obtained by using a long-acting and a short-acting opioid (the short-acting drugs is for breakthrough pain).

    P.S. Pharmacists are a critical part of this process. They are not simply pill counters. They monitor how much medication you are using. Pharmacists are also under obligation to make sure that you cannot obtain your next opioid Rx early. Doing so could cost them their job. Your insurance coverage only allows for a certain number of pills per day. They will not pay to have it filled too early.

    Please determine why you are running out habitually early. If you require a stronger drug because your pain has increased or because you have become tolerant to the current medication, talk to your doctor about it.
    tree62 replied to cweinbl's response:

    I have been seeing my managed pain specialisst for a year. My family dr retired and knew of my history. before he left his practice he was giving me 2 15mg roxicodone per day. before that I was taking 3 7.5 loratabs daily.

    My chronic pain was too much to bear. I suffer from lower/upper back pain, knee pain(2 surgeries) DDD, anxiety,panic attacks and bi-lateral cts.

    I started going to a managed pain clinic and he started me off (after going through 6 months of devastating pain and laying in bed) 4 15 mg roxicodone daily. They work, but as usual they only last 2 if even 3 hours. I do not go anywhere and when i do I grit my teeth and try not to look like a crippled up old woman...I am 50.

    I asked him to increase my pain dosage or how times i can take increased. he said that he can't take all of my pain away. He poo pooed me out of his office and said he hoped he didn't have to fire me. I also see a pysch at his office once a week. the drive is 2 hours one way and waiting twice a month for those words, I don't know what to do or how to approach him again. I have no money, spent it all a year ago and I'm still in the same shape I was from 2011, I know of no other place to go to and I'm afraid of sitting or lying in bed all day again, with no relief...

    any suggestions?
    tree62 replied to tree62's response:
    I also have copd/emphysema..osteophytes, and I should have wrote degenerative disc disease in the lumbar spine with spinal narrowing, along with what I wrote above, including osteoarthritis.

    correction on the phycologist, it's once a month. I see dr for scripts once a month and psyc once a month also..

    They also typed a letter for me, for my disability for medicaid, (which they don't accept). indicating that my pysch reported, that I told them my pain is getting worse or the medication is not helping as well as it did...

    they then said,"we assessed her pain level over the past month and she reported (4) on a scale of 10 w/meds. I would be in heaven if my pain scale was a (4)..why would they lie on the rerport, and they used a report from 7/12 as their assessment. like I said, i'm afraid to make waves and suffer through the pain and depression alone again.
    annette030 replied to tree62's response:
    If they do not accept Medicaid, are their any doctors that do in your area?

    It might be the person who wrote the letter was reading off the wrong chart, it can happen. Just write them a letter with a copy of that enclosed and tell them you never said that and could they double check your chart, and send you a copy of it.

    Take care, Annette

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